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目的观察高原地区高通量血液透析(HFHD)的临床效果。方法选取维持性血液透析3个月以上的终末期肾病患者60例,随机分为HFHD组和低通量血液透析组(LFHD组),每组30例。HFHD组使用FX60,每周血液透析3次;LFHD组使用F7HPS,每2周联合1次在线血液透析滤过(OHDF)。观察两组患者治疗9个月血Scr、BUN、β_2微球蛋白(β_2-MG)、胱抑素C(CysC)、血清钙(Ca)、磷(P)、全段甲状旁腺激素(iPTH)及Hb达标率。利用全国血液净化网路直报数据库计算单次尿素清除率(Kt/v)。结果治疗9个月,两组Ca、P、CysC、iPTH差异无统计学意义(P>0.05),HFHD组β_2-MG低于LFHD组[(16.25±5.92)mg/L vs.(25.12±4.02)mg/L,P<0.05],HFHD组Kt/v高于LFHD组(P<0.05)。HFHD组Hb达标率高于LFHD(36.67%vs.23.33%,P<0.05)。治疗期间两组均未出现致热源反应。结论 HFHD和LFHD+OHDF对于小分子物质清除效果一致,HFHD对中分子物质清除效果好,血红蛋白达标率高。
Objective To observe the clinical effect of high-flux hemodialysis (HFHD) in the plateau. Methods 60 patients with end-stage renal disease over 3 months of maintenance hemodialysis were randomly divided into HFHD group and low-dose hemodialysis group (LFHD group), 30 cases in each group. The HFHD group used FX60 with three hemodialysis sessions per week, and the FHDH group received F7HPS every two weeks with on-line hemodialysis (OHDF). The blood levels of Scr, BUN, β_2-MG, CysC, Ca, P, iPTH ) And Hb compliance rate. Single national urea clearance (Kt / v) was calculated using the National Blood Purification Network Direct Database. Results There was no significant difference in Ca, P, CysC and iPTH between the two groups (P> 0.05). The level of β_2-MG in HFHD group was lower than that in LFHD group [(16.25 ± 5.92) mg / L vs. (25.12 ± 4.02 ) mg / L, P <0.05]. The Kt / v of HFHD group was higher than that of LFHD group (P <0.05). The Hb compliance rate in HFHD group was higher than that in LFHD group (36.67% vs.23.33%, P <0.05). During the treatment did not appear to cause heat source reaction in both groups. Conclusion HFHD and LFHD + OHDF have the same effect on the removal of small molecular substances. HFHD has a good effect on clearing away the middle molecular substances and the high standard of hemoglobin.